Abstract

We describe the case of a 74 year old runner. He came under our observation for the first time at the age of 72 years old, in an apparent state of good health. The basic E.C.G. was normal, the E.C.G. during exercise was indicative of ischemic cardiopathy, without any symptom. The patient refused to undergo further controls. It was possible two years later to examine the patient again. The basic E.C.G. showed anomalies of the ventricular repolarization, the E.C.G. during exercise was again indicative of ischemic cardiopathy. The myocardial scintigraphy with TI 201, during exercise, showed a defect of uptake limited to the upper part of the lateral hinder wall of the left ventricle. It is well known that an attack of myocardial ischemia comes always before a failure of myocardial contractility; this was not found in the athlete we examined; the patient participated in several contests, and he won some of these. Four months after our second visit, the patient suddenly died while he was driving his own car. We have to consider why the patient went on competing in spite of our opposite opinion. The present law considers the elderly runner contests not agonistic, and the fitness is allowed on the ground of the physician visit only. The fact that the athlete is an elderly man justifies a careful evaluation of the cardiovascular apparatus, because it can show a silent myocardial ischemia as in the case we described. Verf.-Referat